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Doctor Visit Request Form

Please fill out the particulars, below if you need to see a medical practitioner, but do not intend to take any sick leave.  If your medical need is of a more urgent nature, please contact the FAO or any bilingual member of the executive.  Once you have submitted this form please call the FAO to book a time to see the Doctor.  This is because there is no guarantee when the FAO may see your form request that is mainly used for administrative purposes.

"Why do I need to fill out this form?"

This form allows the administrative department to determine insurance payments and cost tracking.

    Doctor Visit Request Form

    Please state when you are available during the course of the day and summarise any symptoms as this will assist the FAO in ensuring you visit the relevant medical practitioner.
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